Document 0461
 DOCN  M9550461
 TI    Future treatment strategies in HIV infection.
 DT    9505
 AU    Dormont J; Department of Internal Medicine, Antoine Beclere Hospital,;
       Clamart, France.
 SO    AIDS. 1994 Sep;8 Suppl 3:S31-3. Unique Identifier : AIDSLINE
       MED/95142952
 AB    EFFECTIVENESS OF EARLY TREATMENT WITH ZIDOVUDINE: In terms of
       progression to AIDS-related complex, AIDS or death, clinical trials have
       not yet shown any long-term benefit for early compared with deferred
       treatment with zidovudine. The Concorde trial showed a short-term
       benefit, as did two of the AIDS Clinical Trials Group studies, but the
       number of deaths in these short-term trials was too small to draw
       definitive conclusions. USE OF CD4 CELL COUNTS AS A MARKER OF AIDS: Most
       trials of zidovudine treatment have shown a slower decline in CD4 cell
       counts. However, it is still not clear whether these markers can predict
       long-term survival although they appear to have some value in predicting
       short-term benefits. SECOND-LINE THERAPY: In patients who are intolerant
       of or have failed to respond adequately to zidovudine, treatment with
       didanosine or zalcitabine has shown some short-term benefit, mainly in
       asymptomatic patients or those with AIDs-related complex. No substantial
       long-term benefit was observed. Zalcitabine appeared to show a slight
       increase in survival compared with didanosine. FUTURE PROSPECTS:
       Treatment strategies still being developed include multidrug
       combinations, the combination of a nucleoside with a non-nucleoside
       reverse transcriptase inhibitor, or the use of a combination of drugs
       that affect different stages of the HIV life cycle, such as proteinase
       inhibitors. More sensitive assays, such as RNA polymerase chain
       reaction, may allow treatment to be tailored more closely to the needs
       of the individual patient.
 DE    Acquired Immunodeficiency Syndrome/*DRUG THERAPY/IMMUNOLOGY  Antiviral
       Agents/*THERAPEUTIC USE  AIDS-Related Complex/DRUG THERAPY  Biological
       Markers  CD4 Lymphocyte Count  Didanosine/THERAPEUTIC USE  Forecasting
       Human  HIV Infections/*DRUG THERAPY  Zalcitabine/THERAPEUTIC USE
       Zidovudine/THERAPEUTIC USE  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

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